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<meta name="DC.Title" content="Repeated Head CT in the Neurosurgical Intensive Care Unit: Feasibility of Sinogram-Affirmed Iterative Reconstruction–Based Ultra-Low-Dose CT for Surveillance" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3861" />
<meta name="DC.Date" content="2014-07-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2014 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Patients in the neurosurgical intensive care unit undergo multiple head CT scans, resulting in high cumulative radiation exposures. Our aim was to assess the acceptability of a dedicated, special-purpose sinogram-affirmed iterative reconstruction–based ultra-low-dose CT protocol for neurosurgical intensive care unit surveillance head CT examinations, comparing image quality with studies performed with our standard-of-care sinogram-affirmed iterative reconstruction low-dose CT and legacy filtered back-projection standard-dose CT protocols.

MATERIAL AND METHODS: A retrospective analysis was performed of 54 head CT examinations: ultra-low-dose CT ( n = 22), low-dose CT ( n = 12), and standard-dose CT ( n = 20) in 22 patients in the neurosurgical intensive care unit. Standard-dose CT was reconstructed by using filtered back-projection on a Somatom Sensation 64 scanner. Ultra-low-dose CT and ultra-low-dose CT examinations were performed on a Siemens AS+128 scanner with commercially available sinogram-affirmed iterative reconstruction. Qualitative and quantitative parameters, including image quality and dose, were evaluated.

RESULTS: Sinogram-affirmed iterative reconstruction ultra-low-dose CT represented a 68% lower dose index volume compared with filtered back-projection standard-dose CT techniques in the same patients while maintaining similar quality and SNR levels. Sinogram-affirmed iterative reconstruction low-dose CT offered higher image quality than filtered back-projection standard-dose CT ( P &lt; .05) with no differences in SNR at a 24% lower dose index volume. Compared with low-dose CT, ultra-low-dose CT had significantly lower SNR ( P = .001) but demonstrated clinically satisfactory measures of image quality.

CONCLUSIONS: In this cohort of patients in the neurosurgical intensive care unit, dedicated ultra-low-dose CT for surveillance head CT imaging led to a significant dose reduction while maintaining adequate image quality.

CTDIvol
:   dose index volume
FBP
:   filtered back-projection
IR
:   iterative reconstruction
LDCT
:   low-dose CT
NICU
:   neurosurgical intensive care unit
SAFIRE
:   sinogram-affirmed iterative reconstruction
SDCT
:   standard-dose CT
ULDCT
:   ultra-low-dose CT" />
<meta name="DC.Contributor" content="I. Corcuera-Solano" />
<meta name="DC.Contributor" content="A.H. Doshi" />
<meta name="DC.Contributor" content="A. Noor" />
<meta name="DC.Contributor" content="L.N. Tanenbaum" />
<meta name="article:published_time" content="2014-07-01" />
<meta name="article:section" content="Patient Safety" />
<meta name="citation_title" content="Repeated Head CT in the Neurosurgical Intensive Care Unit: Feasibility of Sinogram-Affirmed Iterative Reconstruction–Based Ultra-Low-Dose CT for Surveillance" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Patients in the neurosurgical intensive care unit undergo multiple head CT scans, resulting in high cumulative radiation exposures. Our aim was to assess the acceptability of a dedicated, special-purpose sinogram-affirmed iterative reconstruction–based ultra-low-dose CT protocol for neurosurgical intensive care unit surveillance head CT examinations, comparing image quality with studies performed with our standard-of-care sinogram-affirmed iterative reconstruction low-dose CT and legacy filtered back-projection standard-dose CT protocols.&lt;/p&gt;&lt;h3&gt;MATERIAL AND METHODS:&lt;/h3&gt;
&lt;p&gt;A retrospective analysis was performed of 54 head CT examinations: ultra-low-dose CT (&lt;i&gt;n&lt;/i&gt; = 22), low-dose CT (&lt;i&gt;n&lt;/i&gt; = 12), and standard-dose CT (&lt;i&gt;n&lt;/i&gt; = 20) in 22 patients in the neurosurgical intensive care unit. Standard-dose CT was reconstructed by using filtered back-projection on a Somatom Sensation 64 scanner. Ultra-low-dose CT and ultra-low-dose CT examinations were performed on a Siemens AS+128 scanner with commercially available sinogram-affirmed iterative reconstruction. Qualitative and quantitative parameters, including image quality and dose, were evaluated.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Sinogram-affirmed iterative reconstruction ultra-low-dose CT represented a 68% lower dose index volume compared with filtered back-projection standard-dose CT techniques in the same patients while maintaining similar quality and SNR levels. Sinogram-affirmed iterative reconstruction low-dose CT offered higher image quality than filtered back-projection standard-dose CT (&lt;i&gt;P&lt;/i&gt; &amp;lt; .05) with no differences in SNR at a 24% lower dose index volume. Compared with low-dose CT, ultra-low-dose CT had significantly lower SNR (&lt;i&gt;P&lt;/i&gt; = .001) but demonstrated clinically satisfactory measures of image quality.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In this cohort of patients in the neurosurgical intensive care unit, dedicated ultra-low-dose CT for surveillance head CT imaging led to a significant dose reduction while maintaining adequate image quality.&lt;/p&gt;" />
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<meta name="citation_author" content="I. Corcuera-Solano" />
<meta name="citation_author_institution" content="aFrom the Department of Neuroradiology, The Mount Sinai Medical Center, New York, New York." />
<meta name="citation_author" content="A.H. Doshi" />
<meta name="citation_author_institution" content="aFrom the Department of Neuroradiology, The Mount Sinai Medical Center, New York, New York." />
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<meta name="citation_author_institution" content="aFrom the Department of Neuroradiology, The Mount Sinai Medical Center, New York, New York." />
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<meta name="citation_author_institution" content="aFrom the Department of Neuroradiology, The Mount Sinai Medical Center, New York, New York." />
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<meta name="twitter:title" content="Repeated Head CT in the Neurosurgical Intensive Care Unit: Feasibility of Sinogram-Affirmed Iterative Reconstruction–Based Ultra-Low-Dose CT for Surveillance" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Patients in the neurosurgical intensive care unit undergo multiple head CT scans, resulting in high cumulative radiation exposures. Our aim was to assess the acceptability of a dedicated, special-purpose sinogram-affirmed iterative reconstruction–based ultra-low-dose CT protocol for neurosurgical intensive care unit surveillance head CT examinations, comparing image quality with studies performed with our standard-of-care sinogram-affirmed iterative reconstruction low-dose CT and legacy filtered back-projection standard-dose CT protocols.

MATERIAL AND METHODS: A retrospective analysis was performed of 54 head CT examinations: ultra-low-dose CT ( n = 22), low-dose CT ( n = 12), and standard-dose CT ( n = 20) in 22 patients in the neurosurgical intensive care unit. Standard-dose CT was reconstructed by using filtered back-projection on a Somatom Sensation 64 scanner. Ultra-low-dose CT and ultra-low-dose CT examinations were performed on a Siemens AS+128 scanner with commercially available sinogram-affirmed iterative reconstruction. Qualitative and quantitative parameters, including image quality and dose, were evaluated.

RESULTS: Sinogram-affirmed iterative reconstruction ultra-low-dose CT represented a 68% lower dose index volume compared with filtered back-projection standard-dose CT techniques in the same patients while maintaining similar quality and SNR levels. Sinogram-affirmed iterative reconstruction low-dose CT offered higher image quality than filtered back-projection standard-dose CT ( P &lt; .05) with no differences in SNR at a 24% lower dose index volume. Compared with low-dose CT, ultra-low-dose CT had significantly lower SNR ( P = .001) but demonstrated clinically satisfactory measures of image quality.

CONCLUSIONS: In this cohort of patients in the neurosurgical intensive care unit, dedicated ultra-low-dose CT for surveillance head CT imaging led to a significant dose reduction while maintaining adequate image quality.

CTDIvol
:   dose index volume
FBP
:   filtered back-projection
IR
:   iterative reconstruction
LDCT
:   low-dose CT
NICU
:   neurosurgical intensive care unit
SAFIRE
:   sinogram-affirmed iterative reconstruction
SDCT
:   standard-dose CT
ULDCT
:   ultra-low-dose CT" />
<meta name="og-title" property="og:title" content="Repeated Head CT in the Neurosurgical Intensive Care Unit: Feasibility of Sinogram-Affirmed Iterative Reconstruction–Based Ultra-Low-Dose CT for Surveillance" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/35/7/1281" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Patients in the neurosurgical intensive care unit undergo multiple head CT scans, resulting in high cumulative radiation exposures. Our aim was to assess the acceptability of a dedicated, special-purpose sinogram-affirmed iterative reconstruction–based ultra-low-dose CT protocol for neurosurgical intensive care unit surveillance head CT examinations, comparing image quality with studies performed with our standard-of-care sinogram-affirmed iterative reconstruction low-dose CT and legacy filtered back-projection standard-dose CT protocols.

MATERIAL AND METHODS: A retrospective analysis was performed of 54 head CT examinations: ultra-low-dose CT ( n = 22), low-dose CT ( n = 12), and standard-dose CT ( n = 20) in 22 patients in the neurosurgical intensive care unit. Standard-dose CT was reconstructed by using filtered back-projection on a Somatom Sensation 64 scanner. Ultra-low-dose CT and ultra-low-dose CT examinations were performed on a Siemens AS+128 scanner with commercially available sinogram-affirmed iterative reconstruction. Qualitative and quantitative parameters, including image quality and dose, were evaluated.

RESULTS: Sinogram-affirmed iterative reconstruction ultra-low-dose CT represented a 68% lower dose index volume compared with filtered back-projection standard-dose CT techniques in the same patients while maintaining similar quality and SNR levels. Sinogram-affirmed iterative reconstruction low-dose CT offered higher image quality than filtered back-projection standard-dose CT ( P &lt; .05) with no differences in SNR at a 24% lower dose index volume. Compared with low-dose CT, ultra-low-dose CT had significantly lower SNR ( P = .001) but demonstrated clinically satisfactory measures of image quality.

CONCLUSIONS: In this cohort of patients in the neurosurgical intensive care unit, dedicated ultra-low-dose CT for surveillance head CT imaging led to a significant dose reduction while maintaining adequate image quality.

CTDIvol
:   dose index volume
FBP
:   filtered back-projection
IR
:   iterative reconstruction
LDCT
:   low-dose CT
NICU
:   neurosurgical intensive care unit
SAFIRE
:   sinogram-affirmed iterative reconstruction
SDCT
:   standard-dose CT
ULDCT
:   ultra-low-dose CT" />
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      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Patient Safety</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Repeated Head CT in the Neurosurgical Intensive Care Unit: Feasibility of Sinogram-Affirmed Iterative Reconstruction–Based Ultra-Low-Dose CT for Surveillance</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">I. Corcuera-Solano</span>, <span class="highwire-citation-author" data-delta="1">A.H. Doshi</span>, <span class="highwire-citation-author" data-delta="2">A. Noor</span> and <span class="highwire-citation-author" data-delta="3">L.N. Tanenbaum</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">July 2014,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1281-1287; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3861 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-13737--6989862681" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">I. Corcuera-Solano </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroradiology, The Mount Sinai Medical Center, New York, New York.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=I.%2BCorcuera-Solano%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Corcuera-Solano%20I&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AI.%2BCorcuera-Solano%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">A.H. Doshi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroradiology, The Mount Sinai Medical Center, New York, New York.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.H.%2BDoshi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Doshi%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.H.%2BDoshi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">A. Noor </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroradiology, The Mount Sinai Medical Center, New York, New York.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BNoor%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Noor%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BNoor%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">L.N. Tanenbaum </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroradiology, The Mount Sinai Medical Center, New York, New York.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.N.%2BTanenbaum%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Tanenbaum%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AL.N.%2BTanenbaum%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> Patients in the neurosurgical intensive care unit undergo multiple head CT scans, resulting in high cumulative radiation exposures. Our aim was to assess the acceptability of a dedicated, special-purpose sinogram-affirmed iterative reconstruction–based ultra-low-dose CT protocol for neurosurgical intensive care unit surveillance head CT examinations, comparing image quality with studies performed with our standard-of-care sinogram-affirmed iterative reconstruction low-dose CT and legacy filtered back-projection standard-dose CT protocols.</p>
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<p id="p-3"><strong>MATERIAL AND METHODS:</strong> A retrospective analysis was performed of 54 head CT examinations: ultra-low-dose CT (<em>n</em> = 22), low-dose CT (<em>n</em> = 12), and standard-dose CT (<em>n</em> = 20) in 22 patients in the neurosurgical intensive care unit. Standard-dose CT was reconstructed by using filtered back-projection on a Somatom Sensation 64 scanner. Ultra-low-dose CT and ultra-low-dose CT examinations were performed on a Siemens AS+128 scanner with commercially available sinogram-affirmed iterative reconstruction. Qualitative and quantitative parameters, including image quality and dose, were evaluated.</p>
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<p id="p-4"><strong>RESULTS:</strong> Sinogram-affirmed iterative reconstruction ultra-low-dose CT represented a 68% lower dose index volume compared with filtered back-projection standard-dose CT techniques in the same patients while maintaining similar quality and SNR levels. Sinogram-affirmed iterative reconstruction low-dose CT offered higher image quality than filtered back-projection standard-dose CT (<em>P</em> &lt; .05) with no differences in SNR at a 24% lower dose index volume. Compared with low-dose CT, ultra-low-dose CT had significantly lower SNR (<em>P</em> = .001) but demonstrated clinically satisfactory measures of image quality.</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> In this cohort of patients in the neurosurgical intensive care unit, dedicated ultra-low-dose CT for surveillance head CT imaging led to a significant dose reduction while maintaining adequate image quality.</p>
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</div><div class="section glossary" id="glossary-1"><h2>ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">CTDI<sub>vol</sub><span class="def-item-dt-sep"></span></dt><dd>dose index volume<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">FBP<span class="def-item-dt-sep"></span></dt><dd>filtered back-projection<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">IR<span class="def-item-dt-sep"></span></dt><dd>iterative reconstruction<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">LDCT<span class="def-item-dt-sep"></span></dt><dd>low-dose CT<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">NICU<span class="def-item-dt-sep"></span></dt><dd>neurosurgical intensive care unit<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">SAFIRE<span class="def-item-dt-sep"></span></dt><dd>sinogram-affirmed iterative reconstruction<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">SDCT<span class="def-item-dt-sep"></span></dt><dd>standard-dose CT<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">ULDCT<span class="def-item-dt-sep"></span></dt><dd>ultra-low-dose CT</dd></dl>
</div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2014 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/35/7/1281.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Repeated Head CT in the Neurosurgical Intensive Care Unit: Feasibility of Sinogram-Affirmed Iterative Reconstruction–Based Ultra-Low-Dose CT for Surveillance</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">I.</span> <span class="nlm-surname">Corcuera-Solano</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.H.</span> <span class="nlm-surname">Doshi</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Noor</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">L.N.</span> <span class="nlm-surname">Tanenbaum</span></span></span></div>
  
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